Dumping Syndrome NCLEX Practice Question Nursing

hey everyone is sayers register nurse re and calm and in this video I want to be going over our weekly in clicks question and don't forget to check out our other free resources to help you study for in clicks so let's get started a patient is post-op from a gastric resection for treatment of peptic ulcer disease one hour after eating meals the patient exhibits diaphoresis tachycardia and hypotension in addition the patient reports feeling abdominal cramps weakness and nausea which options below can be incorporated in the patient's plan of care to help alleviate the patient signs and symptoms select all that apply a wait 30 minutes after meals to consume liquids be sit-up for 30 minutes after eating C consume high amounts of dairy products daily D eat 5 to 6 small meals a day rather than three large meals and E when symptoms present eat cold or hot foods to help decrease symptoms okay so based on our scenario we need to be asking ourselves what is happening to our patient based on what we're seeing and their signs and symptoms we're seeing classic dumping syndrome and how do we know that well there's something in that scenario that should be jumping out at you the first thing is the gastric resection the patient had a peptic ulcer so for treatment they had a gastric resection now what is a gastric resection this is where they go in and they remove the diseased portion of the stomach and for the patient's case it was a peptic ulcer lesion so they removed it and then they reconnected it to the small intestine however this is what it caused problems for the patient because normally whenever they had their whole stomach when they ate food this food would set in the stomach he turned and broke down slightly and then it would slowly enter the small intestine all everything was great but now they're missing part of that stomach so it's losing that ability to turn that food and to break it down instead it's going to rapidly enter into that small intestine hence it's going to be dumped in there too soon and what's really going to cause our problem is that this food that they ate especially if they'd a really rich sugary foods and consumed a lot of liquids it's going to go into that small intestine prematurely and it's going to act as is like hypertonic solution and we learned in our hypertonic hypotonic solution videos what do hypertonic solutions do they like to pull the water from everywhere else to itself so as all that sugary hypertonic solution is in that small intestine what's it going to do it's going to pull all that fluid which is going to cause all these signs and symptoms that this patient is exhibiting so you can have early dumpee which can present about 30 minutes after the patients eat or you can have late dumping which can present anywhere from an hour 3-4 hours after they eat so what's happening is that the harbor tonic solution hits that small intestine that causes a major fluid shift so all this fluid is going to go rapidly to that small investment small intestines are going to swell which is going to cause that abdominal cramping then they're going to start getting some hypotension and tachycardia because you have that fluid shift and that's going to cause the blood pressure to drop and the heart's going to try to compensate by increasing itself to get the blood where it needs to go then what's going to happen is because that fluid is so rich in sugar it's going to stimulate the pancreas to release insulin and then you're going to get a drop in blood sugar hypoglycemia that's really in late dumping so the patient is going to sweat from this they can even get more tachycardic and they're going to get weak and nauseous until very very yucky so this question wants to know what can we incorporate in our patients plant care to help decrease these symptoms because if you've ever taken care of a patient who's there for gastric surgery or Pat or have had a gastric resection they can experience dumping syndrome is common but you can do some things and teach the patient how to do some things to decrease those signs and symptoms so let's with our options okay a wait 30 minutes after meals to consume liquids yes definitely definitely want to do that why well our goal is to limit the amount of volume of solution or GI contents that's going to enter into that small intestine be dumped in there because remember it's five 1/2 a majority of the stomach so we a person eats foods and then they drink liquids with their food such as increasing the volume in the stomach so what we want them to do is eat and then 30 minutes later then consume their liquids so definitely will help with that ok be sit up for 30 minutes after eating no we actually want them to lie down for 30 minutes after eating why because this helps slow the whole gastric infinim process the fitting eyes wouldn't really help lying down a lot of patients report relief with that so that would not be one of our answers ok see consume high amount of dairy products daily no dairy products tend to cause a lot of gastric distress in patients sometimes patients are lactose intolerant and they can get diarrhea so it's good to avoid these types of foods and then they really want to incorporate high amounts of protein and complex carbohydrates because this takes the body a longer time to break down and it will have to do this as it goes throughout the system and it helps stabilize the blood sugar so we really want them to avoid dairy product until later on they can try a small male out and see how they tolerate them and sample carbs and sugary things because remember the rate we're getting a lot of this is because that high amount of sugar content is entering into that small intestine and pulling that fluid so that is not one of our answers okay see eat five to six small meals a day rather than three large meals yes because again our goal is to limit the amount of volume that's entering in that stomach during certain times so we would like for them to eat five small meals a day rather than three huge ones that's a lot going to be dumped into the stomach causing problems so definitely that and let's look at our last option E when symptoms presented cold or hot foods to decrease symptoms know they would not want to do this because actually eating colds that are foods that are really cold or really hot that actually increases gastric motility and emptying and we actually want to slow that process down so we rather than eat room temperature foods or warm temperature they don't need to just eat something super super cold like ice cream or something really hot like hot chocolate because that's going to increase gastric envy so we wouldn't want to do that therefore our answers are a and D and this wraps up our in CLECs review question of the week and don't forget to check out our other NCLEX resources to help you prep thank you so much for watching and don't forget to subscribe to our channel for more videos

Channel: RegisteredNurseRN

Views: 516,741

Keywords: dumping syndrome, dumping syndrome nclex, dumping syndrome usmle, dumping syndrome youtube, dumping syndrome treatment, dumping syndrome pathophysiology, dumping syndrome nursing, nclex questions and answers, nclex question breakdown, nclex questions, nclex question strategies, nclex practice, nclex review

Id: FHDYvhdfqMk

Length: 8min 9sec (489 seconds)

Published: Mon Jul 10 2017